High-risk pathogens were defined as multi-drug resistant (MDR) organisms, which were clustered into four classes: methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales, AmpC-overexpressing Enterobacterales, and Pseudomonas aeruginosa resistant to ticarcillin, imipenem, and/or ceftazidime. Carbapenemase-producing Enterobacterales (CPE), as well as carbapenem-resistant and carbapenemase-producing non-fermenting Gram-negative bacteria (NF-GNB) (Acinetobacter baumanii, Pseudomonas aeruginosa, and Stenotrophomonas maltophilia), were considered difficult-to-treat pathogens.
In each center, the patients had a systematic screening for ESBL Enterobacterales at ICU admission and at least once a week [21 (link),22 (link)]. No systematic screening for other MDR organism carriage was performed. A patient was considered colonized if one of these microorganisms was isolated from their screening sample (perirectal area, nose, any screening sample, or any sample performed because of clinical symptoms).
In each center, the patients had a systematic screening for ESBL Enterobacterales at ICU admission and at least once a week [21 (link),22 (link)]. No systematic screening for other MDR organism carriage was performed. A patient was considered colonized if one of these microorganisms was isolated from their screening sample (perirectal area, nose, any screening sample, or any sample performed because of clinical symptoms).
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